代佑罡, 吴彦秋, 陈宣好, 韦艳, 杨瑶, 祁忠达, 张华. 燃煤型氟中毒地区居民骨吸收标志的变化规律[J]. 环境与职业医学, 2018, 35(7): 613-618. DOI: 10.13213/j.cnki.jeom.2018.17768
引用本文: 代佑罡, 吴彦秋, 陈宣好, 韦艳, 杨瑶, 祁忠达, 张华. 燃煤型氟中毒地区居民骨吸收标志的变化规律[J]. 环境与职业医学, 2018, 35(7): 613-618. DOI: 10.13213/j.cnki.jeom.2018.17768
DAI You-gang, WU Yan-qiu, CHEN Xuan-hao, WEI Yan, YANG Yao, QI Zhong-da, ZHANG Hua. Change pattern of bone resorption markers among residents in coal-burning endemic fluorosis area[J]. Journal of Environmental and Occupational Medicine, 2018, 35(7): 613-618. DOI: 10.13213/j.cnki.jeom.2018.17768
Citation: DAI You-gang, WU Yan-qiu, CHEN Xuan-hao, WEI Yan, YANG Yao, QI Zhong-da, ZHANG Hua. Change pattern of bone resorption markers among residents in coal-burning endemic fluorosis area[J]. Journal of Environmental and Occupational Medicine, 2018, 35(7): 613-618. DOI: 10.13213/j.cnki.jeom.2018.17768

燃煤型氟中毒地区居民骨吸收标志的变化规律

Change pattern of bone resorption markers among residents in coal-burning endemic fluorosis area

  • 摘要: 目的 观察氟中毒地区居民骨吸收标志——血清Ⅰ型胶原交联氨基末端肽(NTx)以及抗酒石酸酸性磷酸酶-5b(TRACP-5b)的变化情况, 为成人氟中毒骨损害机制研究提供资料基础。

    方法 以贵州省六盘水市常年敞灶燃用高氟煤的陡箐乡为氟污染区, 习惯常年烧柴的花嘎乡为对照区, 遵循知情同意原则, 对污染区102名居民和对照区45名居民进行氟斑牙、尿氟浓度及血清NTx和TRACP-5b浓度检测, 并计算氟斑牙指数。

    结果 污染区居民氟斑牙检出率为79.4%, 尿氟浓度为1.59(1.22~2.50)mg/L, 均高于对照区8.8%, 0.65(0.42~1.04)mg/L(χ2=69.669, Z=-6.024, 均P < 0.001)。污染区氟斑牙指数为2.42, 为较显著流行; 对照区氟斑牙指数为0.23, 为阴性。污染区居民血清NTx浓度为12.34(10.93~13.96)nmol/L, 高于对照区的9.21(7.86~12.91)nmol/L(Z=4.062, P=0.000); TRACP-5b浓度为207.87(187.23~251.52)ng/L, 低于对照区的237.36(207.47~305.95)ng/L(Z=2.938, P=0.003)。污染区青年组(18岁~)、老年组(60岁~)居民血清NTx浓度均高于对照区(均P < 0.001);中年组(45岁~)居民血清TRACP-5b浓度为209.86(187.40~276.05)ng/L, 低于对照区的254.07(226.81~305.07)ng/L(Z=2.268, P=0.023)。污染居民血清NTx与血清TRACP-5b浓度呈正相关(r=0.544, P=0.001);污染区居民年龄与氟斑牙程度呈正相关(r=0.242, P=0.014);血清NTx、TRACP-5b浓度与氟斑牙程度无相关性(r=0.065, P=0.516; r=0.009, P=0.932), 与年龄亦无相关性(r=0.010, P=0.918; r=-0.043, P=0.670)。

    结论 氟摄入过量可引起成人血清NTx升高、血清TRACP-5b下降, 且血清NTx浓度和TRACP-5b浓度变化趋势存在一定联系, 两者浓度变化与氟中毒的关系有待进一步验证。

     

    Abstract: Objective To observe the change of bone resorption markers, serum N-telopeptide of type Ⅰ collagen (NTx) and serum tartrate resistant acid phosphatase-5b (TRACP-5b), among residents in coal-burning endemic fluorosis areas.

    Methods Doujing Village, Liupanshui City, Guizhou Province, was elected as the fluorosis area where high-fluoride coal was used as common home fuel, and the control area was Huaga Village where woods were often used. Dental fluorosis, urinary fluoride, serum NTx, and serum TRACP-5b were detected in 102 residents in the fluorosis area and 45 residents in the control area, and dental fluorosis index was calculated.

    Results The detection rate of dental fluorosis of residents in the fluorosis area was 79.4%, higher than that in the control area (8.8%) (χ2=69.669, P < 0.001); the urinary fluoride level of residents in the fluorosis area was 1.59 (1.22-2.50) mg/L, also higher than that in the control area 0.65 (0.42-1.04) mg/L (Z=-6.024, P < 0.001). The dental fluorosis index of residents in the fluorosis area was 2.24, indicating a prevalent dental fluorosis condition; the index in the control area was 0.23, indicating a negative condition. The average concentration of serum NTx in the fluorosis area 12.34 (10.93-13.96) nmol/L was higher than that in the control area 9.21 (7.86-12.91) nmol/L (Z=4.062, P=0.000), and the average concentration of serum TRACP-5b in the fluorosis area 207.87 (187.23-251.52) ng/L was lower than that in the control area 237.36 (207.47-305.95) ng/L (Z=2.938, P=0.003). The average concentrations of serum NTx of the 18-years age group and the 60-years age group in the fluorosis area were higher than that in the control area (Ps < 0.001); the average concentration of serum TRACP-5b of the 45-years age group in the fluorosis area 209.86 (187.40-276.05) ng/L was lower than that in the control area 254.07 (226.81-305.07) ng/L (Z=2.268, P=0.023). For the residents in the fluorosis area, serum NTx was positively correlated with serum TRACP-5b (r=0.544, P=0.001), and dental fluorosis degree was positively correlated with age (r=0.242, P=0.014). No association was found of either serum levels of NTx or TRACP-5b with dental fluorosis degree (r=0.065, P=0.516; r=0.009, P=0.932) or age (r=0.010, P=0.918; r=-0.043, P=0.670).

    Conclusion Over-intake of fluorosis may cause increased serum NTx and decreased serum TRACP-5b in adults, and serum NTx is associated with serum TRACP-5b. But the associations between the two indicators and fluorosis need further verification.

     

/

返回文章
返回